If you ever hear someone getting tripped up over their words
and struggling to say something, the reason could be any number of things:
nervousness, stress, or even simply not knowing what they want to say. It could be a little deeper than that,
however. The person might stutter, which
is a speech disorder that affects about 1% of the US population in which the
speaker’s words may be repeated or last longer than normal. For being one of the more frequent speech disorders though, the average person may not know much about stuttering.
Based on pop culture, students think speech therapy helps
If you were asked to name someone that stutters, who would
you name? Since stutterers sometimes hide themselves, you may need to turn to television
and movies. Porky Pig, Joe Biden, and Marilyn Monroe are all great answers, but
a topical answer would be King George VI, the subject of the recent Academy
Award winning film The King’s Speech. In
the movie, the King has a severe stutter, but meets with a speech therapist and
is eventually able to make a radio broadcast to his country. From the portrayal
of speech therapy in the movie, Georgia McClure and Connor Gibb, both students
at the University of Maryland, believe that speech therapy works and, in
particular, the King’s work with Mr. Logue was a success.There is difference between the media’s portrayal of the subject and what happens in real life, however; the case of King George is an extreme on the stuttering spectrum, and the methods Logue uses are unique to getting the King through the speech. Because of that difference, some readers may not know that while cursing to his heart’s content allowed King George to destress, it wouldn’t help a stutterer talk much smoother in the real world. There are ways to help a stutterer though, and they are based on more recent discoveries to aid in every day communication.
Many options are currently available for stutterers, such as
fluency techniques and fear reduction
Speech therapy for adults who stutter falls into three
categories: operant therapy, fluency shaping, and stuttering modification. Many approaches are required because each
stutterer is different and will need a different technique to streamline their
speech. They all work toward the same goals however: to provide comfort with
spontaneous communication, to allow for controlled fluency, and to cultivate a responsibility
for change and growth.
The first of the three approaches, operant therapy, is based
on the research of B.F. Skinner in the 1930s and works to increase fluency through
positive reinforcement. When a client
exhibits fluent speech, they are given praise, and when they show stuttering,
slight negative reinforcement. The idea is that eventually the client will
exhibit their desired speech pattern after repeated conditioning.
Fluency shaping, the second of the three methods, gives the client control of the way they talk; it teaches techniques to speak smoother such as slowing the rate of speech, breathing management, monotone speaking, and easy onsets, which are a way to ease yourself onto a word rather than stutter. This method gives the speaker a fast way to not stutter; when they do not want to stutter, they can change their speech in a way that avoids the disfluencies. However, the method is criticized that the resulting speech does not sounds like normal speech, sometimes sounding slow or airy. Fluency shaping is employed by the three week intensive therapy program at the American Institute for Stuttering in New York.
The final
approach, stuttering modification, is the most in depth; it attempts to modify
the moment a stutter happens as well as the root of many problems, the
thoughts and fear that can trigger stress and shame in a person who stutters. The therapy labels the positive techniques of
fluency shaping as negative “tricks” to avoid stuttering that should be reduced in speech, and
focuses heavily on self-acceptance of being a person who stutters and embracing
feared situations. Vivian Sisskin, an instructor in
the University of Maryland Department of Hearing and Speech Sciences, says that
struggle in speech is actually caused by attempting to avoid struggling, a very
paradoxical phenomenon.
Fluency shaping, the second of the three methods, gives the client control of the way they talk; it teaches techniques to speak smoother such as slowing the rate of speech, breathing management, monotone speaking, and easy onsets, which are a way to ease yourself onto a word rather than stutter. This method gives the speaker a fast way to not stutter; when they do not want to stutter, they can change their speech in a way that avoids the disfluencies. However, the method is criticized that the resulting speech does not sounds like normal speech, sometimes sounding slow or airy. Fluency shaping is employed by the three week intensive therapy program at the American Institute for Stuttering in New York.
The final
approach, stuttering modification, is the most in depth; it attempts to modify
the moment a stutter happens as well as the root of many problems, the
thoughts and fear that can trigger stress and shame in a person who stutters. The therapy labels the positive techniques of
fluency shaping as negative “tricks” to avoid stuttering that should be reduced in speech, and
focuses heavily on self-acceptance of being a person who stutters and embracing
feared situations. Vivian Sisskin, an instructor in
the University of Maryland Department of Hearing and Speech Sciences, says that
struggle in speech is actually caused by attempting to avoid struggling, a very
paradoxical phenomenon.
She encourages her clients, through the stuttering
modification method offered at the clinic on the College Park campus, to “desensitize”
to their stuttering through exercises that allow the client to show their
stuttering to others, such as asking for directions and voluntarily
stuttering. Sisskin says that, as
backward as it may sound, you must “stutter your way out of stuttering.”
Stuttering Modification Method is hard to measure, but the
results are impressive
Each of the three methods of speech therapy, operant, fluency
shaping, and stuttering modification, is measured on a different scale. All of the methods work towards the same goal
of comfortable speech, as Sisskin explains, but can be distinguished in their
reports.
Operant therapy looks at whether the client shows stuttering
and struggle or not, and fluency shaping is measured by how smooth the client’s
speech is compared to when he first entered therapy. The method can be given a percentage of
success, such as 80% of disfluencies removed. Sisskin questions, however, how truly
successful these methods are, whether the client is prone to an easy relapse
into old stuttering habits. While
fluency shaping provides a definite percentage of success, stuttering modification,
with its multilayered approach, is much harder to measure. As a client removes their “tricks” to hide
stuttering, they will sound less fluent than before, but it is a step in the process
to eventually speak more smoothly and with comfort. The method also focuses on the client’s
thought process and situational avoidance, which is qualitative and cannot be
easily measured, which is why, Sisskin says, of the three methods, it is the
least supported by scientific research.
Looking at the results, however, provides a sense of the power of
stuttering modification. Many past
clients of the clinic are now in high profile jobs as lawyers and actors, and
are facing situations that they once feared with pride and relatively comfortable
speech.
Speech therapy is a highly individualized item, and some
options will be better suited for each person who stutters. In the end though, the goal is to make a
stutterer’s life easier and more comfortable, which is the real success, and there
are success stories from users of each method. As for King George, Sisskin
describes the King’s techniques as “strategies for effective speech,” and
questions whether the tricks would translate to his everyday interactions.
